Flutamide
Flutamide is an anti-androgenic that blocks androgens by competitive inhibition of receptors, reducing androgen synthesis (50). A combination of flutamide and COCs improved acne by 80% (35). Flutamide at low dosage of 62.5 mg daily or 1 mg/kg/day seems to be a safe and effective for treating acne in women (51). Side effects include breast tenderness, gastrointestinal upset, insomnia, and fatigue (52, 53).